Retroperitoneal organs of the posterior abdominal wall Flashcards
Abdominopelvic cavity
Peritoneal cavity
Retroperitoneal space
Retroperitoneal organs
Mesentery/ peritoneum over its anterior surface only
Examples:
- aorta
- IVC
- kidneys
- suprarenal glands
Some are termed secondary retroperitoneal organs
Examples
- pancreas
- duodenum
- asc + desc colon
Urinary organs
Kidneys- produce urine
Ureters- conveys urine to bladder
Urinary bladder- temporary reservoir
Urethra- empties bladder to outside the body
Kidneys location
Posterior abdominal wall
Related to posterior abdominal wall muscles
- diaphragm, superior
- psoas major, medial
- quadratus lumborum, posterior and lateral
Superior pole T12
Inferior pole L3
Right slightly lowered
Kidneys gross anatomy
Bean shaped
11x6x3 cms
Surface partly ‘touched’ by peritoneum
Right
- right suprarenal gland
- liver
- right colic flexure
- duodenum
Left
- left suprarenal gland
- stomach
- spleen
- pancreas
- left colic flexure
- jejunum
Kidneys internal anatomy
Two distinct regions: cortex and medulla
Cortex- glomerulus
Medulla- renal pyramids (collecting ducts)
Cortex and renal pyramids- parenchima
Parenchima: functional kidney (nephrons)
VAN- hilum of kidney
Renal pelvis (ureter)
Renal artery - aorta (just below SMA)
Renal vein - IVC (anterior to artery)
Differ left and right
Lymphatics: drain to lateral aortic nodes
Functional kidneys
Regulation of blood
- ionic composition
- pH
- volume
- pressure
- osmolarity
Production of hormones
Excretion of wastes and foreign substances
Suprarenal glands
Located over kidneys
Separate from kidneys in own fascial compartment
Shape: pyramidal (right), semilunar (left)
Inner anatomy: cortex, medulla
Vessels: suprarenal arteries, suprarenal veins
Nerves: abdominopelvic
Function suprarenals
Cortex
- corticosteroids
- sex hormones
Medulla
- adrenaline
Ureters
Very muscular ducts
25-30cms from renal pelvis to bladder
3 constrictions (kidneys stones):
- ureteropelvic junction
- crossing iliac vessels
- entering bladder
Blood supply from several sources (renal, aorta, iliac)
Bladder and urethra
Located in the true pelvis
Bladder: inverted pyramid with urethra at apex
Urethra: duct from 4cms (female) to 20cms (male)
Urethra: urinary in female; reproductive/ urinary in male
Passes under pubic symphysis; cross pelvic floor muscle to reach genitals
Kidneys- injury
Protected by perirenal fat, ribs, vertebral column
Crush against ribs or column
Brusising to laceration
Rapid blood loss
Renal pain
Stretching capsule, spasm smooth muscle of renal pelvis
Afferent fibres in renal plexus follow parallel to symp fibres
- least splanchnic nerve
- symp trunk
Pain referred to cutaneous area of T12- territory of subcostal nerve
Renal colic
Peristaltic waves of ureter in attempting to pass a stone
Agonising pain- skin over area supplied
Severe pain spreads to CNS (nausea)
Enter spinal cord at level T11-L2
